tv Dr. Kelli Harding The Rabbit Effect CSPAN October 9, 2019 9:05pm-9:58pm EDT
large tech companies like amazon, google and uber. good evening and thank you to the strand book room. my name is nancy. for a little bit of history, the store was founded by my grandfather, benjamin, in 1927. and then my dad who passed away, tried and it was part of the famous crow that ran along fourth avenue just one block away from astor place to the union square and there were 48 used bookstores that all competed with one another. we are doing 400 events and discussions just like the one tonight and even tonight we have
four events happiness is the best medicine yet americans will spend $3.4 billion on medicine and health care this year, a sum that is large enough to send any family of four that check for $40,000 for their care. and we all know that happiness is not a big ticket item. our guest tonight doctor kelli harding will discuss this. she is an assistant professor of psychiatry at columbia university medical center and a diplomat to the american board of psychiatry and neurology. she works up a room as at the
hospital and as the daughter of a 91-year-old and spent a lot of time there so i have a lot of admiration, she has appeared on today, good morning america, npr, "new york times" and the u.s. news and world report. doctor harding is here as the author of "the rabbit effect." [applause] starting with the story of a nurturing feed of rabbits, she discusses the groundbreaking new research that shows how love, friendship, community and environment and life's purpose can have a greater impact on our health than anything that happens in a doctors office. joining doctor harding in conversation is doctor lloyd and adjunct professor at the columbia school of public health
was for 12 years the chief medical officer for the new york state office of mental health, the nation's largest state mental health agency where he continues there as a distinguished psychiatric advisor. he's written many books including the one we have here tonight, addiction solution trading our dependency on opiates and other drugs. she's also written a family guide to mental health care and improving mental health, more secrets in plain sight. please join me in welcoming doctor's harding to the strand for this important discussion. [applause]
so first of all, thank you so much for having us and that beautiful introduction. it is such an honor to be here at the bookstore. i mean really i didn't grow up in new york and the strand has a mystique to it to be sitting here among these books is just one of the highlights of my life so thank you so much. and to be surrounded by so many people that i absolute free love, this is just an incredible treat. i've seen so many faces from so many different. so thank you so much. because this is a book about kindness we also just wanted to take one second and if you can
say hello to your neighbor and introduce yourself if you don't know them. [inaudible conversations] good evening. we wanted to get to know you a little bit more. how many of you are from the mental health field flex how many of you are writers, journalists? a special form of writers. let me ask this. how many of you are here tonight
because you are a relative of doctor harding? [laughter] how many of you are here because you are her neighbor and relying on her medical advice? [laughter] and anybody here is that because you think it is a book about vampires? because it's not. that must be in one of the other rooms. [laughter] some of you are also probably wondering what is the deal with these rabbits, so we will talk about that. let's learn a little bit more about you, kelli. we heard that you have a pretty busy life as an emergency room
dr.. you have three children. how in the world did you gather at the timthe time and energy te this book? >> this book is an incredibly important message. it became something that it felt urgent. i know this is something that you also share a passion about and that comes back to public health. it affects every single person sitting in this room. >> as clinicians, raise your hand if you are a clinician. as clinicians there is a love of
mystery when it comes to the mismatch between what we expect when we know about it and what actually transpires in life and in the hospital. on paper they may sound like they are not doing well but in fact they are functioning and living their life fully. the flipside of that, patients who may be when you look at their lab and imaging and everything else maybe they are not functioning in life. it has to do with the mind and body connection i ended up with a research fellowship booking of medically unexplained symptoms until i heard about the rabbits.
this book was part of your discovery of what you have been searching for i think you might want to hear about these rabbits studies. i think you heard something about them how the social world impacts them but he didn't quite know the detail so i searched and finally tracked down peace studiethesestudies in the late r done with the intention of looking at heart health and rabbits and at the time it wasn't known as a high-fat diet made a difference, so these are sort of genetically identical. one of the groups have far better health outcomes than different markers than the other groups of markets and being a
terrific scientist figured there was something wrong with the protocol said he looked at it again. a very caring woman who was actually picking up the rabbit, wasn't just giving them cable but having them she was talking to them and they realized could be a socia the social environmes actually changing their physiology like this. it was a radical idea they went ahead and replicated the study with a condition and got the same results. i just want to take a step back because a lot of the studies are somewhat serendipitous. this is a groundbreaking study showing that the world was having an impact but the thing
is. when something makes sense you don't dismiss it, you pursue it. it protected them from disease, that is a phenomenal thing to discover. >> somehow our social world is changing our physiology and that decides our understanding of how the body works right there but then trying to think about the mechanism and what's amazing is we have for decades of science since then every single person
in this room, every single person listening on c-span, their lives are impacted by the kindness that they are giving others and the kindness that they are receiving. it comes back to so many different factors related to mental health and that is where we enter the discussion. >> and you described these as hidden factors. i described them as hidden factors and it is what they call the social determinants which is a bit of a mouthful but the thing to keep in mind is that it's all these in our day-to-day relationship so we are talking about what is happening in our home. what's happening in our schools,
communities, neighborhoods, and our broad social environment is compounding to really take care of one another. i want to take a second to think about kindness so let's just take a second and think about somebody that has shown kindness recently just for a couple of seconds. for me it's easy because i'm looking out at the sea of people that have done that and sitting next to me so thank you. it's those things kindness makes us feel good but there's also this amazing science and emerging like really cool stuff about how the body works and how
science and actually implement it into the day-to-day and you have a certain mindset so the goal of this book i realized this is information that needs to be every single person in this room stand because they need to recognize their actions do matter. a bigger predictor by far is your workplace. we think about health like diets, sleep, exercise, and occasional trip to doctor. for better or worse, how our stress levels are impacting ourr hopes on a day-to-day basis and it is the conversation that we need to be talking about because the other perth is a big piece to this is mental-health and we know in this country mental health isn't something that has
been, there's there's a lot ofa and you have seen it first-hand throughout your career. how do you connect loneliness to these problems with health and reaching one another and kindness? >> it comes down to taking care of one another. so, when we think about it and loneliness is a big piece of it, so there's all this date now but actually loneliness is as detrimental to your health is very well-established risk factors expecting 15 cigarettes a day.
how many times does your doctor asked if you smoke or drink but are they asking you when is the last time you called a good friend or someone you care about if things got rough what you have somebody that you could reach out to come and it turns out that his really critical. so it's time that we started talking about it. >> have you gotten a bit of a hard time from your colleagues for saying that we are missing the bullet when we are asking about smoking or drinking or asking about missing this whole aspect of the relationship parts of our lives when is the last time a doctor asked about that. and do you have a hard time with your colleagues? >> i would love to hear from colleagues in the room about this. there are records i was just talking about this with the medical students. record numbers of burnout among physicians and people who work in medical care and i think a big piece of that is because the
current system is just simply not acknowledging the major determinant of health which brings me to a statistic. medical care probably only accounts for about ten to 20% of our overall health. so, just think about that for a second, ten to 20%. but when it comes to how we spend on health care in this country, we are spending 95% of our dollars on medical care and administrative costs. that being said, it's important, access to medical care is absolutely critical that the same time we have to start looking at a bigger picture of health and that includes what is happening in our communities and thinking about the school system and all these other things that typically we some want minimized in that sort of glare of the razzle-dazzle of biomedicine which i loved it, i am a total science nerd.
>> is it hard to be kind, what are the barriers? what's getting in the way? it is something you have to do every day because we are human beings and we fail at it all the time. i think this exciting is we can recognize it as somethin is somo strive for and i am not talking grand measures of kindness where you are donating buildings to various places or things like that, but looking at the person that gives you a cup of coffee in the morning we are talking really basic human decency things and talking about how we are treating other people, the promise of our society. how are we treating people that are not as fortunate as we are? >> is strong in this different?
>> it's already in the medical world when we talk about i would say when we talk about all these social factors it boils down to for me it was one of the great pleasures of writing the book was actually hearing my wonderful editor debate how do you talk about this to people who are not necessarily scientists or academics and it came down to kindness and it's really true because that is the golden thread that runs through all of this and it's got this amazing ripple effect. because if you act with kindness
towards someone else, they may continue to it just feels good when somebody does something nice for you and put a hand on your shoulder when you are having a rough time or when you know somebody has your back. i mean, really, we know those things make us feel better but now it's cool because we are getting the science to show it's so we've got to do more of it and i just want to also say i feel lucky because this room is filled with people that i know have had my back and i am just so grateful to you. >> that is another important idea that you have advanced as a practice which is gratitude. tell us about the practice of gratitude. >> i think what is so cool about kindness but also kindness towards others and an easy way
to do that is to start with gratitude the gratitude and mindfulness these are all good for our body it comes down to stress so it's things that is an inevitable part of life. i love how you talk about stress in your work and it's one of those things we have to think about offers because we know stuff comes up and that is a big part of the book to the resilience and also reserve of stress buffers stuff comes up that it isn't just on the floor. >> of the inflammatory process is a phenomenon in our bodies that you've emphasized and it's central to the development of disease and disability. how is kindness and antidote to
the response? what's happening here, help us understand this. >> this for me is some of the coolest science the narrow immune system basically, like not understanding how that was working into sort of explains to the patients i was seeing during my research fellowship, patients who just are not feeling well but we cannot quite find something wrong on our sort of traditional path and that is probably because they are not sort of measuring some of the writings necessarily, but i think that is also cool about it is, you know, in this country we tend to sort of separate line and the body and we do that in a very physical way when it comes to mental health we have a sort of separate mental health places of care. we don't think of people -- there is a doctor for every bit of your body coming and we've got some super sub specialized. on the one hand, it is helpful but on the other hand we still
need to be stepping back and looking at these bigger pictures, and it's these conversations that are going to be happening at bookstores and communities around the country. >> are you asked by your readers or friends to coach them about how to talk to their doctor about the inflammatory response about kindness, about the social factors, how do people go about bringing this up with their dr.'s? >> it's been fascinating and i would be curious to hear your experiences. people tell me i have this one doctor that is phenomenal and they are asking these kind of questions. part of it is our system, the way that currently people in healthcare are paid up to ask other social life in a ten minute very focused visit, ten minutes is kind of if you are lucky. it feels like opening up the lid of pandora's box.
so, there are one of the key ways i've been talking about in the book raise your hand if you are familiar. you've been taking the lessons to heart. so, one of the things that actually thinking about experiences that happen and it's something present in our environment all the time, kind of like smoking used to be back in the 1940s, people didn't really think that smoking causes lung cancer. i figured out many years before they figured out this is causing all kinds of diseases across the board, so it turns out, is actually one of those things and it's something that we are not really talking about and many doctors don't know if there's a sort of easy test you can even take online. it is called aces to hide where you can see about the histor thf
trauma. the crazy thing is every other person you pass on the street has some history of trauma in their past and there is a lot of shame and stigma around it so people don't talk about it necessarily, but it actually comes back to the question what do you do when you encounter somebody that is unkind because we know that hurt people hurt people and sometimes if somebody is being very unpleasant it can be helpful to keep that in mind but that is actually part of the story because i really, people think like kindness is great until suddenly there is a stressful situation or somebody is yelling at you or cut you off in traffic or whatever it may be, but again it's like kindness is actually about conflict resolution, like how do we navigate our world and here are other people's differences in a way that you know, we are able to actually come to some problem solving. it's absolutely no secret we are not doing a very good job of that right now and putting people at other camps.
for our society and health, we need to be having more conversations where we are able to create a bridge. >> trauma is a very big concept. what are some examples of the kind of experiences children have that leaves them with this residue of for perhaps the rest of their lives within inflamed byron system. >> so the data shows that instances tha that happened durg childhood can have a lifetime consequence when it comes to health. this was first studied in obesity is, and it was at that time yet again another incidental finding that just seemed too curious to let go and so what's interesting about it is the sort of things with the loss of a parent, witnessing abuse, many of the things we would sort of think about being very harshly talked to, things we might necessarily think about as trauma or on tha on that list
is really empowering as we have some ability using trauma informed therapy that come in all different modalities and i see the heads shake. it comes in art, mental health, yoga, like there's all kinds of ways people are addressing the trauma that they have had to come and it actually seems to make a difference for their bodies which is amazing. >> these can be identified early in a child's life. when that happens, what can be done to help spare that child that kind of persistent problem? >> a big part of it, a lot of the work is being done in california where it isn't just what is happening in the clinic so you do a little screening and identify and then from there a lot of the resources are things in our community, but this isn't necessarily the kind of thing we are supporting with our current
healthcare system. the thing is a lot of intervention to make a huge thae difference on health are really actually quite low cost and what i talk about in the book and the rapid effect is also you know, these are things that you don't necessarily have to have a white coat to have. in fact i would say the vast majority of the program you just have to have the good intention, and there's lots of wonderful health educator programs that are out there and there's ways to get involved and i just also want to say this because this is one example of like hundreds that are in the book. it blows my mind because it turns out that actually volunteering is good for your health. you live longer. anything you are interested in you want to get out there and try to get involved in and here is the other cool thing. it turns out education is probably, do we have any teachers in the room? okay i'm seeing some hands go up. it turns out that you are really in the healthcare business because education saves way more
lives than it turns out biomedicine does and the statistic as a physician was absolutely mind boggling. for every one life saved by biomedicine come education saves eight. so, think about that. i went to medical school to help people, but it turns out that again you really don't need a white coat to help people, you can help people in many ways. you can do a lot and i've got some absolutely incredible students in the room so i don't want to minimize that, but i do also want to say that all of you who are sitting here are participating in the health of you, you your families, theand e communities whether you know it or not, so you want to try to start making a difference in any way that you can and i know this because i know like man don't lu you are all super kind. one thing that has changed in my life with this because now i'm really making a point of reaching out to people when i see someone in need i don't just
necessarily walk by. i tried to think of something creative i could do that would be helpful or even just little things in our day-to-day. >> are there other ways this book has changed hugh? in the writing and now the speaking. >> i would say actually the biggest change has happened in the last week. this book just came out and i was sharing earlier with nancy and lloyd that i didn't think anybody would show up at the meeting because i actually come and gone will remember we were shopping this idea around in the somebody said kindness of those and so but here's the thing it's incredibly heartwarming. it turns out that, i'm falling out of my chair because of it. it turns out people care a lot about kindness, and we are at a critical point where we are
starting to talk about it, but it's not okay how we are treating each other and it's actually time to make important change and it's going to require all of us to really start looking at the problem and stop bothering people. >> that is a very good message to leave us always and maybe now there are some comment or questions from you, our guest. >> if you have a question if you would like to raise your hand we can run a microphone to you. >> thank you so much for the talk and getting us to get copies of the book for everybody that we know. >> miami happiness engineer and i do this for a living. my question to you is the response whether it is receiving
or giving. >> actually, that raises an important point. we talk a lot in this country about how people are in a lot of pain and they typically have been looking for a pill or a visit to the doctor's office to solve it, but i think like you just have to do a google search and look up what comes up and you say why do i feel so come int, it'slike why do i feel so y do i feel so alone, and think about that because the antidote to that is not necessarily going to come in a pill that we can overdose on. thankfully, i can't remember a single case in the emergency room of somebody overdoing it on kindness. [laughter] >> i have a question. when you see somebody that he appears to be mentally ill on the street, what should you do about that? >> i actually feel like this is better at -- i can tell you what
i do but -- >> please. >> so, he ran mental health for new york state for over a decade, said he is very well-equipped to do this. there are many different things. first i would start with is, you know, obviously your safety comes first. you want to ask if the person, like ask them their name, say are you okay, the wanting to call somebody, those are some of the things i typically do. and then actually because it is often the same people, you notice in the new yorker, how could it be that we are in this glorious city with these incredibly, incredible resources but yet there are still so many people on the streets, so many people still with mental illness that are not getting adequate treatment into this and even necessarily people with severe illness, it is run-of-the-mill, depression and anxiety are not getting treated, so i think one
of the key things that do this is if any of you are interested in getting trained for mental health were first aided his checking in with people you don't have to be a clinician. this is an example of the health program they are doing an awesome job with it on the foundation with lady .in her mom, sort of training people up to be able to address issues of mental health and in a more systematic way because again it isn't just a guy on the street. it's the kid at school, the guy in the workplace that having a hard time. it's all those people we need to be creating a more inclusive community with. >> so many of us may be tongue-tied at the moment with somebody that is in distress. there was a campaign in australia. a very simple question for everybody in the country and the campaign was called are you okay.
i think what you are describing. and also, the first person experience. when you ask somebody not only are you okay, but what is your name. >> this brings the human element that you are describing. >> that is exactly it and it's getting at that human element because it is so easy to other people and so whatever the circumstance whether it is somebody on the street or somebody that doesn't necessarily shame to -- share the same political views is just easier to put people in another camp and it's probably how we have survived overtime, but we also have these incredible brains that can help us overcome that and the key is recognizing these hidden factors and also recognizing your actions are having a profound effect and i think that some of the most lovely piece of this is that
sometimes just one action of kindness can make a real difference in somebody's life in a way that you may not ever anticipate. one thing i felt very fortunate as a clinician is sometimes people will come back and say you really made a difference when you did this one thing and i think i can't believe it because it isn't always appreciated at the time. so, -- >> of their comments or questions? >> we've been mostly talking about the kindness therapy or whatever you want to call it with normal folks. now i'm curious how does the kindness therapy training with somebody that is psychotic or in the hospital, schizophrenic, how does that work? >> that is a really good question. >> is a great question.
>> i think we also have to look at how we are treating people in the hospitals because raise your hand if you have ever stayed in any sort of hospital or care for somebody in a hospital, i know i have. sometimes it is easy to lose the person getting the medical care, the human being involved for all the medical care. so, part of that is by design, but we also have to really be thinking about the humanistic element of the person that is getting the care and i think we can do a lot better job. some of that research comes looking at how medical care is delivered in other countries. i think we are starting to make inroads to it because it used to be this like visiting hours were cut off at certain times, but now it is much more inclusive because people often do better in the family is by their side. i see a lot of heads shaking. it makes so much sense like in
other countries that is often ie norm and it's now become the norm here. so, for westernized medicine just to come back to the big population data again, we are really not doing a good job, we are spending a huge amount of money but at the same time when you look at our outcomes they are really not where they need to be, like across the board we are just not doing as well as a lot of other wealthy countries are doing when it comes to rates of obesity, premature death, high blood pressure, homicide, suicide, all these things. we need to acknowledge that we are missing a big piece of the puzzle. so, again i think if you asked me earlier how clinicians respond, i dream a lot of positive support from clinicians because i think that they are recognizing that we all are into medicine to help care for people and to really fix the problem that failed a patient if you are not addressing some of this.
>> i'm wondering about the connection between mindfulness and kindness as you were explaining because if we talk about just taking the time to look someone in the eye and say thank you for the cup of coffee i think in new york we are in this and go go go kind of mode and i want your thoughts on the connection between that and kindness. >> said, mindfulness, there's probably experts in the room that are mor more in this than , but there is compelling data now beyond just niceness there's also a meditatio meditation pra, gratitude practices, there is a whole buffet of different mindful practices that you can pick and choose what works for you and your lifestyle or anything. i think actually the meditation able to clinicians i hear joking it's like we all know the data it is just overwhelmingly good,
but to actually sit down and be still for ten minutes, 20 minutes a day it is very hard. it takes practice. i would say just number one there's the data showing that it's very helpful for health and it's also because it is reducing the stress level it's having now it is like a cascade of epigenetic changes. there's this cool research. it used to be like your genes were your destiny that now there is this science that shows they are much more invaluable than we realize that it is because of the way that they are sort of like folding and responding to the environment and there are the school studies where it is basically showing that you can make positive changes even somebody that is living with illness based on doing things right mindfulness practices and lowering your risk of recurrent stroke or heart disease.
that is incredible. the data if it came as a pill every one would take it. it's so robust that it's because it requires a practice it isn't necessarily an easy fix. >> but it's very inexpensive. >> it is. hello, thank you so much. >> what is your name? >> stephanie. >> there are so many just to that point there are so many applications out there right now whether it is called more simple habit or any of those. is there one that you like in particular any sort of way to look at it that you think is good? >> i would say to do what works for you because of th if the kes just to practice element of it, i tried a bunch of them and in fact actually with my kids we got like a band across the head where it shows your pain wave and there is some cool ones out
there. i've had a lot of friends tell me different ones work that you don't even necessarily need an application. you can just practice even stillness for five minutes and it makes a big and, it's really amazing. we are a go-go culture. good evening. thank you for a lovely evening in new york. >> hell did you hear about the top? >> i was out walking and came here and i'm kind of stuck on what to do for my last night so i thought i would invest in a book. [applause] i have an 18 hour train journey tomorrow so this will come in handy. [laughter] i'm just interested in what you think if there is a coalition between bicultural inclusivity in the sense that certainly when it comes to politics in britain at the moment struggling with
the disaster and that is certainly like i've seen in my society of a huge division between people, and we have become and a lot of people didn't have the correct information, there's a lot of fear for some people and it was even, you know, walking around some areas of new york such cultural diversity. but a lot of it is very sector off and i wonder if you think the public health service is creating cultural inclusivity in the part of the program or with regards to politics. i feel like politicians kind of separate us and there's a public sole factor to kind of address that. >> i would say this is actually probably topic number one when it comes to public health and many of the med students the audience know that you are talking about health disparities and how able are treated
differently in the hospitals. it's pretty unbelievable, and it isn't always over. it's often done with sort of the best of intentions that when you look at the data in fact we were just talking the other day about a study that showed surgeons for african-american patients versus white patients were like over 70% more likely to recommend imputation versus for the white patients. that kind of data is like even okay there's a margin of error by 20% it is still totally unacceptable. so, that is probably a really big area. one of the things i talk about in the book is also our unconscious biases. it's something that we probably everybody's got them. i talk about and about some of them i discovered which the medical students take. the test isn't perfect to show
that you are biased in this way that the idea can just get you thinking that maybe you are doing things like micro- aggression or other things that may be harmful because micro mio aggressions are the sort of pulled equivalent of death by a thousand paper cuts. >> we have time for two more questions. >> hello, kelly. >> hello. i haven't read the book yet but i look forward to it. do you talk about the impact of the internet and how that disconnects us. while the ups can be helpful if you look for the younger generation especially we talk about how it is a lonely generation, the increase of loneliness and the impact that it has. did you look at that at all or think about that? >> that comes into play particularly there is an early
chapter on our one-to-one relationships. we are all doing this incredible experiment with our children right now, so i think they just called it as very on the huffington is calling its generation alpha so it is our first generation that's really grown up as my kids age and many of the people in the rooms kids age where they have never not known technology. but there are these really interesting well-known studies like looking at your phone and not looking at another human face has all these downstream consequences and we are doing it pretty much every day to each other. just next time you are on the subway, look around and you will notice how few people are not engaging with one another they are just sort of sitting and looking at their phones. you will now see a couple of dictating which i think is pretty cool. but it's actually got something for me that has changed a lot and trying to be much more
intentional about my phone usage. it's hard because it's like then you end up totally behind on e-mail and not seeing some important messages. as a society we are kind of grappling with it and i certainly don't have a solution that but i would say let's keep working on it because again the face-to-face interaction is the most critical thing. i think in lieu of the last question actually we have one more question. >> hello, gabrielle. one, as an individual going through trauma as a child undiagnosed, what would be some suggestions you have for them now as an adult and then the second half of that is if you do see an adult or child in trauma what are some suggestions as a friend or family member that we can do for them? >> what a wonderful question. the first step would be to actually dig into some of the resources and that is a good thing to think about being a
mental health professional. so, but luckily if you are here in new york city, there are a lots of it is a good thing. and they can give you or anyone options that are tailored to their needs. the second piece of it is when it comes to childhood actually the most innovative clinics are giving things that are involving -- because it is and the doctor's responsibility to take care of all of this. we need more interdisciplinary teams. this is something psychiatry has done for decades. they are quite good at is that even getting better and that is a thing we need to be investing in social work. we've got experts social work people in the room we need to be investing in more therapists and a more pure health educators and using things that are evidence-based to try to reduce that. there are some in terms of trauma that doesn't necessarily involve a therapist some amazing studies looking even at the power of writing and how that can make a difference. writing things for like 15 minutes a day for three days in a row has been significantly
shown to reduce the stress around. so it's pretty amazing that these interventions are out there, but the key thing for us i guess as to just start talking about them and look for solutions together because it is a big topic. it's a big book. we cover it a lot. actually if it is okay the last thing i would like to do in closing is just to think, also may be what you might do tomorrow morning to offer a little kindness to somebody in a different way than you were expecting and if you could turn to your neighbor and offer them a little kindness like thank you for coming or something like that. >> thank you so much for coming. [inaudible conversations]
up next on booktv mary gray gives us a behind the scenes look at the work force that drives large tech companies like amazon, google and her and the theoretical physicist offered his thoughts on quantum mechanics. >> welcome, everybody. thank you very much for coming. i'm delighted to see you all here. i'm a faculty member at the economic department and one of the cochairs of the task force that was commissioned by the president a year ago last spring and the purpose of the task force is to sort of engage and come front the sense that many have bee in the labor market technology is changing rapidly to understand why people